| NPI | 1053335737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE L SULLIVAN Office Manager 270-769-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 18096) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-01-05 |